Provider Demographics
NPI:1265936959
Name:KREITZMAN, NATALIE R
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:R
Last Name:KREITZMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 GILL LN APT 12C
Mailing Address - Street 2:
Mailing Address - City:ISELIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08830-2831
Mailing Address - Country:US
Mailing Address - Phone:732-841-6015
Mailing Address - Fax:
Practice Address - Street 1:323 GILL LN APT 12C
Practice Address - Street 2:
Practice Address - City:ISELIN
Practice Address - State:NJ
Practice Address - Zip Code:08830-2831
Practice Address - Country:US
Practice Address - Phone:732-841-6015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-19
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00041500235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist